In a strong show of unity, the AAFP and other major physician organizations met with House and Senate leaders Dec. 13 on Capitol Hill in a final push to avert a deep reduction in the Medicare physician payment rate on Jan. 1.

AAFP Board Chair Glen Stream, M.D., M.B.I., (left) and Charles Cutler, M.D., chair-elect of the board of regents for the American College of Physicians, take part in a briefing with other physician groups shortly before meeting with House and Senate leaders Dec. 13 on Capitol Hill.

AAFP Board Chair Glen Stream, M.D., M.B.I., of Spokane, Wash., and the leaders of four other physician organizations -- the AMA, the American College of Physicians, the American College of Surgeons and the American Osteopathic Association -- met with Republican and Democratic leaders to stop a 26.5 percent cut in the Medicare physician payment rate that is scheduled to take effect on Jan. 1 as a result of the sustainable growth rate (SGR) formula. Physicians also are facing an additional 2 percent cut in the Medicare physician payment rate on Jan. 2 due to the Budget Control Act's sequestration provision.

"We had good and frank discussions about the SGR and the critical importance of avoiding the end-of-the-year cuts," said Stream in an interview with AAFP News Now.

Stream and the other physician leaders also discussed the importance of replacing the SGR with a more equitable and stable payment system, effectively presenting congressional leaders with a two-part SGR request: First, prevent the impending cut, and then eliminate the SGR next year. Congressional leaders were very receptive to both requests, Stream said. "There really is strong support in the House and the Senate and in both parties about avoiding the impending cuts, but there is not agreement about how to pay for a Medicare payment patch."

Stream and the other physician leaders implored lawmakers to not pay for a Medicare payment extension by cutting funding for graduate medical education (GME) or by eliminating a provision in the health care reform law to bring Medicaid payment rates at least to Medicare levels for the next two years. The AAFP is spearheading opposition to a House proposal that would pay for a yearlong extension of the Medicare physician payment rate by eliminating the Medicaid-Medicare parity provision.

During the past few weeks, the AAFP has issued a number of Speak Out alerts, asking members to contact their legislators in Washington to voice opposition to the House proposal and to urge lawmakers to not cut GME funding to finance a payment fix. In addition, the AAFP and 43 of its state chapters, along with most of the nation's other major physician organizations, signed a joint letter to House and Senate leaders expressing strong opposition to the proposal. Stream and the other physicians referenced the letter during discussions with legislators.

In their discussions, Stream and the other physician leaders stressed that they are seeking a permanent solution to the ongoing cycle of deep Medicare cuts called for by the SGR, as well as congressional intervention to block the reductions. "We were not there asking for more money just to prevent payment cuts to physicians," said Stream. "We recognize that the current system is unsustainable -- that it doesn't promote quality. We want to transition to a better system, and we want certainty and stability during that transition."

Like physicians, lawmakers also are "tired and frustrated with the SGR," according to Stream. He said there is a growing consensus in Congress to eliminate the SGR as part of a possible larger budget deal between Congress and the White House next year. "I think we are closer than we have ever been," said Stream. But, "a repeal is not going to happen by the end of the month."

As a result, AAFP members need to keep contacting their legislators to tell them the impending Medicare payment cuts are not acceptable, Stream said. "If enacted, the cuts will have an adverse impact on physician practices and on the patients that we serve. We just can't let that happen."